title: Faecal short-chain fatty acid pattern in childhood coeliac disease is normalised after more than one year's gluten-free diet.
abstract: OBJECTIVE
  Recent work indicates that the gut microflora is altered in patients with coeliac disease (CD). Faecal short-chain fatty acids (SCFAs) are produced by the gut microflora. We have previously reported a high SCFA output in children with symptomatic and asymptomatic CD at presentation, as well as in CD children on a gluten-free diet (GFD) for less than 1 year, indicating deviant gut microfloral function. In this report, we focus on faecal SCFA production in coeliacs on GFD for more than 1 year.
  
  
  METHODS
  Faecal samples were collected from 53 children with CD at presentation, 74 coeliac children on GFD for less than 1 year, and 25 individuals diagnosed with CD in childhood and on GFD for more than 1 year. The control group comprised 54 healthy children (HC). The faecal samples were analysed to show the SCFA pattern taken as a marker of gut microflora function. We applied a new fermentation index, reflecting the inflammatory activity of the SCFAs (amount of acetic acid minus propionic acid and n-butyric acid, together divided by the total amount of SCFAs).
  
  
  RESULTS
  In coeliacs on GFD for more than 1 year, the individual SCFAs, total SCFA, and fermentation index did not differ significantly from the findings in controls. In contrast, the faecal SCFA level was clearly higher in coeliacs treated with GFD for less than 1 year compared to those more than 1 year.
  
  
  CONCLUSIONS
  This is the first study on SCFA patterns in faecal samples from individuals with CD on GFD for more than 1 year. Our study indicates that the disturbed gut microflora function in children with CD at presentation and after less than 1 year of GFD, previously demonstrated by us, is normalised on GFD for more than 1 year.
authors.affiliation: Department of Microbiology, Tumor and Cell Biology, Karolinska Institute, Stockholm, Sweden ; Department of Paediatrics in Norrköping, County Council of Östergötland, Norrköping, Sweden.
authors.forename: Bo
authors.initials: B
authors.lastname: Tjellström
authors.forename: Lotta
authors.initials: L
authors.lastname: Högberg
authors.forename: Lars
authors.initials: L
authors.lastname: Stenhammar
authors.forename: Karin
authors.initials: K
authors.lastname: Fälth-Magnusson
authors.forename: Karl-Erik
authors.initials: KE
authors.lastname: Magnusson
authors.forename: Elisabeth
authors.initials: E
authors.lastname: Norin
authors.forename: Tommy
authors.initials: T
authors.lastname: Sundqvist
authors.forename: Tore
authors.initials: T
authors.lastname: Midtvedt
keywords: children; coeliac disease; faecal short chain fatty acids; gluten free diet; gut microflora